VCOM Research Day Program Book 2023

Medical Student Research Publ ic Health

02 Hysterectomy Trends for Texas Medicare Recipients

Brenner Johnson OMS-2, Alex Bauer OMS-2, Nicholas L Rider, DO Corresponding author:

Liberty University of Osteopathic Medicine

cysts). We computed frequencies for hysterectomy by indication and approach within our population in comparison to a large, published US Cohort (Wright et al., 2013) using Fisher's exact test. Results: We note significant differences in the routes used for hysterectomy surgery in the US Medicaid cohort compared to the national benchmark. The laparoscopic route was used significantly more in the US Medicaid cohort for bleeding (p <0.001), leiomyoma (p= 0.016), malignancy (p= 0.001), and endometriosis (p= 0.023). The abdominal route was used significantly less in the US Medicaid cohort for bleeding (p= <0.001) and leiomyoma (p= 0.001). There was no significant difference in cohort frequency for use of the vaginal route to treat prolapse (p= 0.56).

Objective: We reviewed the diagnostic and procedure codes associated with hysterectomies obtained from a US Medicaid cohort to understand patterns of care within a traditionally medically underserved population. Our principal aim was to ascertain differences in surgical approach frequency across indications in comparison with a national benchmark. Methods: Using 12-months of claims data from a single-payer, Medicaid population (n=427,110 individuals) we restricted our analysis to subjects who had undergone a hysterectomy (n=30). We then extracted procedure codes and enumerated counts across 3 surgical approaches (abdominal, vaginal, and laparoscopic for 5 typical indications (Bleeding, Prolapse, Endometriosis, Malignancy, Leiomyoma/

Conclusions: Aligning with recently published reports of hysterectomy care, analysis of this US Medicaid cohort suggests a trend towards adopting the laparoscopic approach. Our analysis suggests that Medicaid patients are receiving standard hysterectomy care. Limitations of this study include lack of clear demographic and age differences between the cohorts studied which may shed light on differences noted above.

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